Terms in this set (47)
What is osteoporosis AKA?
T or F: Osteoporosis is the most common metabolic bone disorder resulting in low bone density
What is osteoporosis characterized by?
Loss of bone mass and fragility
What happens in osteoporosis?
Spongy bone is lost first, and then the compact bone is lost; this results in thin fragile porous bones
What are pt. with osteoporosis at a high risk of?
Define pathologic fracture
Low impact break. The bone is very weak and diseased so it does not take trauma or a severe incident to break the bone.
What is the primary cause of OP?
1) Males in their 70's +
2) Post menopausal woman
3) 1-2% of bone lost per year for 5-7 years post menopause
4) Increased rate of osteoclast activity in post-menopause woman
What is the secondary cause of OP?
1) Steroid therapy
2) ETHO and smoking-acidosis-bone loss
3) Endocrine issues-hyperparathyroid issues
4) Imbalanced nutrition
6) Kidney transplant
7) High phosphorous
8) Low calcium intake
What are some non-modifiable risk factors of OP?
2) Family history
3) Post menopausal
4) Female, Caucasian
5) History of fractures
6) Small, thin frame
What are some modifiable risk factors of OP?
Corticosteroids and anti-convulsants
Calcium intake is too low, lack of Vitamin D
Estrogen levels too low
What is the gold standard diagnostic technique that measures bone density?
DEXA Scan [Measures bone density in the hip or lumbar spine]
What is evaluated with the DEXA scan?
T score and Z score
What does the T score measure?
Compares a person's bone density with a HEALTHY 30 year old of the same sex
What does the Z score measure?
Compares a person's bone density with an average person of the same sex
A T-score of -2.5 or lower indicates
A T-score of -1 to -2.5 signifies
Who should receive DEXA Scans?
What are important labs to review?
2) Urine and serum calcium
3) Vitamin D
5) Liver and renal function [excretion and metabolism]
6) 24 hour Urine for Ca+
What is important to consider for the 24 hour urine Ca+?
Thiazide diuretics can increase Ca+ in the urine
Drugs containing Na+ and Mg+ can increase Ca+ in the urine
Is ERT recommended or used to prevent osteoporosis? If so or not, why?
Can cause breast CA, CV problems, DVT
What therapy can be done for men?
Androgen therapy to decrease bone resorption [loss]
What is an example of an androgen therapy drug?
Testosterone Proprionate [Testex]
Why is Selective Estrogen Receptor Modulators used? provide an example
Increase bone mass density b/c it mimics estrogen
What is a SE of SERM?
What is an SERM drug?
What is an example of a parathyroid hormone drug?
Administered SQ to post-menopausal woman with fracture risk
Increases serum Ca+ levels
How is Calcitonin administered
What is the MOA of calcitonin?
Inhibits osteoclast activity [prevents bone break down]
Why is calcium supplements important? Provide 2 examples of calcium supplement drugs
Promotes good bone health
Calcium may cause:
What an reduce Ca+ absorption?
excessive ETOH, protein or salt intake
What can enhance Ca+ excretion?
Caffeine, sode or meats, increased stress
What is Caltrate-D?
Combination of vitamin D and calcium
Vit. D is needed for Ca absorption
What is the most common treatment for osteoporosis?
What are some biphosphates?
Fosamax, Boniva, Actonell
What do biphosphates do?
slow bone resorption [loss]
What is a common complication of biphosphates?
it will erode the esophagus. take early in the morning with a lot of water and remain upright for 30-45 minutes after taking it
What is an IV biphosphate?
What is a complication SE of Aredia, Reclast?
What is a test that should be done frequently?
Liver function test
What s/s should you educate the client about?
What are s/s of vitamin D toxicity?
Which drug can cause epigastric distress?
Fosamax, Boniva, Actonell
Tell pt. to report bloody emesis
What is the most common complication of OP?
The injection of bone cement into the verterbral body to fill the space caused by osteoporosis
Verterbroplastly that consists of the use of a balloon to elevate the fracture and return the vertebrea to a more "normal" position